[Fluid therapy without glucose in neurosurgery. Effect on glycemia].
BACKGROUND
Glucose administration to patients about to undergo neurosurgery must be avoided because perioperative cerebral ischemia in a context of hyperglycemia worsens the neurological prognosis. Furthermore, prolonged hypoglycemia can also provoke lesions that resemble those occasioned by states of ischemia-hypoxia.


OBJECTIVE
To evaluate glycemic changes in patients undergoing craniotomy who have not received glucose-containing solutions.


METHODS
Forty-six patients were enrolled and assigned to two groups according to whether they received perioperative corticoid treatment (CC, n = 24) or not (NCC, n = 22). Fasting was maintained without administration of glucose-containing solutions. We measured glycemia, natremia and potassemia at baseline and 60 minutes after surgery.


RESULTS
Demographic characteristics, duration of surgery (5.0 +/- 1.6 h in the CC group and 4.6 +/- 1.4 h in the NCC group) and fasting period (18 +/- 2.3 h in the CC group and 17 +/- 1.9 h in the NCC group) were similar in both groups. Glycemia increased and natremia decreased significantly in both groups, with no clinical repercussions. No case of perioperative hypoglycemia occurred. Initial potassemia in the CC group was significantly higher than in the NCC group, but decreased after surgery with no clinical repercussions. No relation was found between fasting time, duration or surgery and differences in glycemia between the two groups.


CONCLUSIONS
Non-administration of glucose in patients undergoing craniotomy eliminates the risk of hyperglycemia, does not lead to perioperative hypoglycemia and is not affected by perioperative corticoid treatment.
Ornaque-Lázaro
I
I
Servicio de Anestesiología y Reanimación, Hospital Clínic i Provincial, Barcelona.
Fábregas-Julià
N
N
Valero-Castell
R
R
Carrero-Cardenal
E
E
Salvador-Gozalbo
L
L
Gambús-Cerillo
P
P
D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011188:Potassium / Q000097:blood; D012964:Sodium / Q000097:blood
D001786:Blood Glucose; D012964:Sodium; D011188:Potassium
Fluidoterapia sin aporte de glucosa en neurocirugía. Repercusiones sobre la glucemia.